Lacayo, Marlene A

Lacayo, Marlene A is an sole proprietor health care provider with primary practice located at 1323 Bia Route 4 , Fort Thompson SD 57339-0200. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Lacayo, Marlene A can be contacted via phone (605) 245-1518.

Contact Information

Primary practice address
1323 Bia Route 4 Fort Thompson SD 57339-0200
Fax: (605) 245-2150
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 45-710 New York

Profile Details

NPI number 1801814512
LBN Legal business name Lacayo, Marlene A
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 18th, 2006
Last updated Nov 29th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801814512 NPPES
South Dakota MEDICAID 5549010

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